This proposal builds on a randomized trial that examined three promotional strategies - reminder postcard, a short reminder telephone call and a telephone-based motivational interview - designed to increase mammography screening among women 50-79 years of age (NCI 1R01CA063188, S. Taplin, PI). Relative to the postcard the two phone-based approaches significantly increased participation in mammography screening within one year, but there were no statistical differences between the two telephone-based approaches. We found, however, that due to the higher cost of the two telephone-based approaches, the reminder postcard was the most cost effective strategy for increasing short-term participation in the screening program. We now propose to study long term patterns of mammography use among women enrolled in the trial based on their socio-demographic, cancer risk factors and barriers to screening. We will assess the impact of the brief intervention to examine whether there are different long term effects of the motivational interview with respect to what we observed in the short run and we will examine the long term cost effectiveness of efforts to increase participation in a breast cancer screening program. Our research goals are: 1. Evaluate patterns of mammography use over time and evaluate the long-term impact of the motivational interview on women receiving mammograms at the recommended two year screening cycle will be greater among women without a prior mammogram at baseline, women with a greater perceived risk of breast cancer and among women with greater self reported barriers to screening. 2. Estimate the long-term cost effectiveness of the motivational interview from both a health plan and a social perspective. In conjunction with this aim we will test the following hypotheses: 3. Develop optimal strategy of targeted promotion based on women's perceived risk of breast cancer, barriers to mammography and personal history with respect to preventive health care. To our knowledge the long-term impact of brief promotional messages to increase mammography use has not been studied. The results of our study will help guide researchers and policy makers in planning and implementing brief interventions for a wide range of health behaviors.